The Empire State Medical Association is highly concerned about the claims by Michael Worobey that “AIDS virus invaded the United States in about 1969 from Haiti, carried most likely by a single infected immigrant who set the stage for it to sweep the world in a tragic epidemic”.

We reject the comments that “researchers think an unknown single infected Haitian immigrant arrived in a large city like Miami or New York, and the virus circulated for years -- first in the U.S. population and then to other nations.”

Gilbert and Worobey, analyzed samples from only five of these Haitian immigrants dating from 1982 and 1983. They also looked at genetic data from 117 more early AIDS patients from around the world. This genetic analysis allowed them to calibrate the molecular clock of the strain of HIV that has spread most widely, and calculated when it arrived first in Haiti from Africa and then in the United States. The researchers virtually ruled out the possibility that HIV had come directly to the United States from Africa, setting a 99.8 percent probability that Haiti was the steppingstone.

For Haiti, the history of HIV/AIDS represents stigma, discrimination, and racism. In 1982, scientists at the Centers for Disease Control (CDC) incorrectly inferred that Haitians were at increased for acquiring HIV as a racial group (1). HIV/AIDS therefore became known as the “4H Disease”, affecting homosexuals, heroin addicts, hemophiliacs, and Haitians. This resulted in unprecedented national stigmatization and devastating economic, social, and psychological consequences, decimating the tourist industry in this island nation. As reported at the time: “Haiti has been made an international pariah by AIDS. Boycotted by tourists and investors, it has lost millions of dollars and thousands of jobs at a time when half the work force is jobless. Even exports are being shunned by some (2).” In 1985, when it became clear that Haitians share the same risk factors as other groups, the CDC dropped the Haitian association, but it was too late. HIV and Haiti were inextricably linked in the minds of the general public. Haiti's economy has never recovered.

Gilbert et al once again link HIV and Haiti, stating: “Subtype B likely moved from Africa to Haiti in or around 1966” and then on to the U.S. Their entire hypothesis is based on virus isolated from five Haitian-Americans who were living in Miami in 1982-83. No other information is provided except that they “entered the U.S. after 1975 and progressed to AIDS by 1981 and hence were presumably infected with HIV-1 before entering the U.S.” A host of questions remain. What were their risk activities? Where had they traveled? Did they have sex with Americans in Haiti? We do know that the average time of progression of HIV infection to AIDS and to death in the pre-ART era was 4.5 and 7.4 years, respectively – these intervals are consistent with the five subjects acquiring the infection in the U.S, which limits the validity of their findings (3). The authors go on to state: “The HIV-1 epidemic in Haiti exhibits a greater range of viral genetic diversity that the rest of the world's subtype B combined”. The authors have not studied the virus in Haiti. Where are the data to support this claim?

They also state that their aim is to combine phylogenetic, molecular evolutionary, historical, and epidemiological perspectives in an attempt to reconstruct the history of the subtype B pandemic. However, epidemiology studies conducted in Haiti do not support the author's hypothesis. If the virus was in circulation in Haiti since 1966, there would not have been a much higher male: female ratio in the early years of the epidemic (80% of the first Haitian patients were male in the early 1980's) which rapidly generalized as they spread the virus to their female partners (4,5). In addition, reviews of large samples of banked blood from the 1970's failed to yield a single case of HIV and thousands of autopsies did not diagnose an AIDS defining illness until 1978 (6). Furthermore, only one case of Kaposi's sarcoma (KS) was noted by Haitian dermatologists prior to 1979 (7). KS is easily recognizable and it would not have been missed by Haitian dermatologists for over a decade.

Haiti has overcome enormous obstacles and mounted one of the world's most successful responses to the HIV/AIDS epidemic. Yet, the authors restate prejudices advanced two decades ago in the publication of Pitchenik et al (8): “Haitians in Haiti and elsewhere are at risk of AIDS”. People of all ethnicities in every country are at risk. Scientists need to be very responsible in their assertions, lest they do great harm.

The American public must also be informed that European scientists infected many Africans with contaminated polio vaccine that was cultured with Chimpanzee kidneys. This is a fact. This theory as an etiology of AIDS was outlined in 1999 in the book, The River: A Journey Back to the Source of HIV and AIDS and the Canadian documentary entitled the “Origin of AIDS”. Hooper mapped the locations where Koprowski's CHAT vaccine was given and where the earliest cases of AIDS were discovered. It showed a dramatic geographical correlation. Text from an interview with Mr. Hooper on the book and movie are as follows:

Edward Hooper: "The earliest cases of AIDS occurred in central Africa, in the same regions where Koprowski's vaccine was given to over a million people in 1957-1960. I think that what we have here is the route whereby this chimpanzee virus arrived in humans."

Hooper claims that kidneys from chimpanzees infected with SIV were used to grow the polio virus during Dr. Koprowski's 1950's vaccination campaign. Archival footage confirms that a large number of chimpanzees were housed at Camp Lindi, located upstream from Koprowski's medical laboratory in Stanleyville in the former Belgian Congo.

But in his book Hooper provided evidence to show what happened to the four hundred chimps brought to the camp and killed in the space of two years.

Camp assistant Christophe Bayelo, cared for the chimps at Lindi. He told Hooper that the staff, including Paul Osterrieth, the lab's head of virology, systemically harvested organs from the camp's chimps.

Joseph Limbaya, a nurse at the camp remembers that he was ordered to kill two or three chimps a day. Joseph Limbaya: "We didn't remove the flesh, but the two organs located at the back, the two balls called the kidneys."

The camp workers claimed that some of the animals were dissected alive. Hooper argued that the main reason for doing so would have been to harvest living tissue cultures needed to make the polio vaccine.

Paul Osterrieth and Hilary Koprowski steadfastly denied that chimpanzee tissue was used to grow the polio virus in the Congo.

Before his death Pierre Doupagne, the chief technician at the laboratory of Stanleyville admitted to Edward Hooper that he made sterile tissue culture from chimps for Paul Osterrieth.

Edward Hooper: "The person with overall responsibility for this entire sequence of events is Dr. Koprowski. Without his approval, this sequence of events would not have taken place."

Bill Hamilton, a renowned evolutionary biologist, felt that Hooper's theory had merit. In an interview with CNN he explained why he felt it was necessary to take a closer look.

Bill Hamilton: "I feel it's not only the origin of AIDS that is in question here, it is the conduct of science towards the hypothesis, which has been one of paranoid rejection. I think I would not exaggerate to describe it as medical science's worst hated hypothesis."

Hamilton traveled to Africa to collect chimpanzee samples but contracted malaria and died in March 2000. Before his death he asked the Royal Society of Scientists in London to stage a debate on the 'hunter vs. the vaccine' theory of the origin of AIDS.

In September 2000 the world's top AIDS specialists assembled at London's Royal Society for a conference on the origins of AIDS. It was meant to give Edward Hooper a chance to present his evidence to the scientific community.

From the opening of the conference arguments were launched against Hooper's theory. Then there was a surprise announcement. Samples of Kopowski's CHAT vaccine had been located and tested and found not to have any trace of HIV, SIV or chimp DNA.

This announcement was viewed by the scientific community as a decisive statement against Hooper's theory. Articles were published in Nature and Science concluded that Hooper's hypothesis was not viable.

Dr. Cecil Fox: "They (the scientists), once again, claimed to have laid to rest the idea that HIV could have come from Polio vaccine and I don't think they did a better job than they had done before. There are still great gaping holes in their story."

However Hooper pointed out that the samples were discovered in the U.S. and not used in the Congo and that no vaccines still exist from that time.

In 2003 Michael Worobey returned to the Congo to complete the studies attempted by Bill Hamilton years ago. In a scientific paper published in April 2004 they concluded that the SIV found in the chimpanzees near Stanleyville was not the strain that crossed over to humans to cause HIV years ago. The authors stated that this provided proof evidence against the polio vaccine theory.

In response, Edward Hooper claims that the chimps used at Camp Lindi came from a large geographical area then tested by Worobey. And he maintians, this means that the researchers cannot claim to have put the issue to rest. He plans to publish a book this year in support his theory.

Although Koprowski insists that his polio vaccine could not have sparked the AIDS epidemic, he was one of the key scientists to convince the U.S. government to make polio vaccines with synthetic cells in 1997 and coincidentally the earliest cases of HIV developed in the areas he worked in European French colonial Africa.